[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 771 Introduced in House (IH)]
114th CONGRESS
1st Session
H. R. 771
To amend title XVIII of the Social Security Act in order to strengthen
rules applied in case of competition for diabetic testing strips, and
for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 5, 2015
Ms. DeGette (for herself, Mr. Reed, and Mr. Whitfield) introduced the
following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committee on Ways and Means, for a
period to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act in order to strengthen
rules applied in case of competition for diabetic testing strips, and
for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Protecting Access to Diabetes
Supplies Act of 2015''.
SEC. 2. STRENGTHENING RULES APPLIED IN CASE OF COMPETITION FOR DIABETIC
TESTING STRIPS.
(a) Special Rule Applied in Case of Competition for Diabetic
Testing Strips.--
(1) In general.--Paragraph (10) of section 1847(b) of the
Social Security Act (42 U.S.C. 1395w-3(b)) is amended--
(A) in subparagraph (A), by striking the second
sentence and inserting the following new sentence:
``The volume for such types of products shall be
determined through the use of multiple sources of data
that measure consumption and utilization of diabetic
testing strips among individuals in the United
States.''; and
(B) by adding at the end the following new
subparagraphs:
``(C) Demonstration of ability to furnish types of
diabetic testing strips.--With respect to the program
described in subparagraph (A), the Secretary shall
reject a bid submitted by an entity if the entity does
not, as part of the demonstration to the Secretary
described in such subparagraph submitted by the entity,
demonstrate that the entity has an ability to furnish
the types of diabetic testing strips included in its
bid, including an ability to obtain and maintain an
inventory of such strips by volume in a manner
consistent with its bid.
``(D) Use of unlisted types in calculation of
percentage.--In determining under subparagraph (A)
whether a bid submitted by an entity under such
subparagraph covers 50 percent (or such higher
percentage as the Secretary may specify) of all types
of diabetic testing strip products, the Secretary may
not attribute a percentage to types of diabetic testing
strips that the Secretary does not provide the entity
with the option to identify by type and market share
volume.
``(E) Contract requirement.--Any contract entered
into with an entity for diabetic testing strips under
the competition conducted pursuant to paragraph (1)
shall include a requirement that the entity offers,
makes available to, and maintains in inventory of (or
otherwise has ready access to, such as through
purchasing contracts) each of the types of diabetic
testing strip products that is included in the bid
submitted by the entity. In the case that an entity
enters into such a contract with the Secretary and
fails to fulfill the requirement described in the
preceding sentence, the Secretary shall terminate such
contract.
``(F) Monitoring adherence to demonstration.--The
Secretary shall establish a process to monitor, on an
ongoing basis, the extent to which an entity that
enters into a contract with the Secretary for diabetic
testing strips under the competition conducted pursuant
to paragraph (1) adheres to the demonstration that the
entity provided to the Secretary under subparagraph
(A).''.
(2) Conforming amendment.--Section 1847(b)(3)(A) of the
Social Security Act (42 U.S.C. 1395w-3(b)(3)(A)) is amended by
adding at the end the following new sentence: ``In the case
that such a contract is for diabetic testing strips, such
contract shall include the information required under paragraph
(10)(E).''
(b) Codifying and Expanding Anti-Switching Rule.--Section 1847(b)
of the Social Security Act (42 U.S.C. 1395w-3(b)), as amended by
subsection (a)(1), is further amended--
(1) by redesignating paragraph (11) as paragraph (12); and
(2) by inserting after paragraph (10) the following new
paragraph:
``(11) Additional special rule in case of competition for
diabetic testing strips.--
``(A) In general.--With respect to diabetic testing
strips furnished by an entity to an individual under
the competitive acquisition program established under
this section, the entity shall furnish to the
individual the brand of such strips that is compatible
with the home blood glucose monitor selected by the
individual.
``(B) Prohibition on influencing and
incentivizing.--An entity described in subparagraph (A)
may not attempt to influence or incentivize the
individual described in such subparagraph to switch the
brand of glucose monitor or testing strips selected by
the individual, including by--
``(i) persuading, pressuring, or advising
the individual to switch such brand; or
``(ii) furnishing information about
alternative brands to the individual in the
case that the individual has not requested such
information.
``(C) Provision of information.--An entity
described in subparagraph (A) may not communicate
directly to an individual described in such
subparagraph until the entity has verbally provided the
individual with standardized information, to be
supplied to the entity by the Secretary, that describes
the rights of the individual with respect to the
entity. The information described in the preceding
sentence shall include information regarding--
``(i) the requirements established in
subparagraphs (A) and (B);
``(ii) the right of the individual to
contact other mail order suppliers of diabetic
testing strips or to purchase such strips at a
retail pharmacy in the case that the entity is
not able to furnish the brand of such strips
that is compatible with the home blood glucose
monitor selected by the individual; and
``(iii) the right of the individual
described in subparagraph (D) to reject
diabetic testing strips furnished to the
individual by the entity.
``(D) Individuals allowed to switch from unwanted
products.--
``(i) In general.--The Secretary shall
establish a process under which an individual
furnished with diabetic testing strips under
the competitive acquisition program established
under this section may reject the strips by
notification, including notification by
telephone or electronic mail, to the supplier
and to the Secretary.
``(ii) Consequences of rejection.--In the
case that an individual rejects diabetic
testing strips under clause (i)--
``(I) any payment made to the
supplier under this title for a portion
of such strips furnished for use during
the period beginning with the date on
which the individual rejects the strips
shall be recovered by the Secretary;
and
``(II) the individual may obtain
different diabetic testing strips from
a supplier, and the Secretary shall
process a claim for such different
diabetic testing strips without regard
to any benefit or coverage limitations
arising from the fact that a claim has
already been submitted and payment made
for the rejected diabetic testing
strips.
``(iii) Prohibition on future claims.--In
the case that an individual rejects diabetic
testing strips under clause (i), the supplier
who supplied the rejected diabetic testing
strips to the individual may not submit
additional claims for payment on behalf of the
individual for the type or brand of diabetic
testing strips so rejected by the individual,
unless the individual makes a separate
expression of consent to the supplier to be
furnished with such type or brand of diabetic
testing strips by the supplier.''.
(c) Effective Date.--The amendments made by this section shall
apply with respect to diabetic testing strips furnished on or after
July 1, 2016.
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